title: Searching for an optimal hand hygiene bundle: a meta-analysis.
abstract: Many studies have evaluated bundled interventions to improve hand hygiene compliance. However, there are few evidence-based recommendations on optimal interventions for implementation. We aimed to systematically review all studies on interventions to improve hand hygiene compliance to evaluate existing bundles and identify areas of promise to target high-quality studies. Adjusted risk ratios were pooled to assess common bundles. Of the 8148 studies evaluated, 6 randomized controlled trials and 39 quasi-experimental studies met inclusion criteria. Three studies evaluated the interventions education, reminders, feedback, administrative support, and access to alcohol-based hand rub as a bundle, which was associated with improved hand hygiene compliance (pooled odds ratio [OR], 1.82; 95% confidence interval [CI], 1.69-1.97). Another bundle of education, reminders, and feedback evaluated in 3 studies was associated with improved compliance (pooled OR, 1.47; 95% CI, 1.12-1.94). These bundles should be further studied using high-quality study designs and compared with other interventions.
authors.affiliation: The Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System.
authors.forename: Marin L
authors.initials: ML
authors.lastname: Schweizer
authors.forename: Heather Schacht
authors.initials: HS
authors.lastname: Reisinger
authors.forename: Michael
authors.initials: M
authors.lastname: Ohl
authors.forename: Michelle B
authors.initials: MB
authors.lastname: Formanek
authors.forename: Amy
authors.initials: A
authors.lastname: Blevins
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Ward
authors.forename: Eli N
authors.initials: EN
authors.lastname: Perencevich
mesh_terms: D019983:Guideline Adherence / Q000706:statistics & numerical data; D063373:Hand Hygiene / Q000379:methods*; D006268:Health Facilities; D006282:Health Personnel; D006801:Humans; D017053:Infection Control / Q000379:methods*; D064872:Patient Care Bundles / Q000379:methods*
keywords: bundle; hand hygiene; intervention; meta-analysis